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A model to analyse costs and benefit of intensified diabetic foot care in Austria

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Abstract Rationale, aims and objectives 

The diabetic foot is a common late complication among diabetic patients and due to its consequences an important financial burden for society. Intensified treatment has proved to reduce amputation rates, but in Austria so far no data have been available about financial implications and long-term effects of intensified treatment. The objective was to retrieve cost data for intensified treatment of diabetic foot ulcers and to estimate the long-term outcome. Methods 

A retrospective data analysis of 119 ulcers was done to get outcomes and costs for intensified treatment in a specialized outpatient hospital department in an Austrian setting. One-year results were categorized according to the San Antonio wound classification. Using a Markov model upon these data, long-term outcomes and costs for intensified treatment and for standard care were calculated. Results 

Costs for intensified treatment until healing vary from €1071 (range: 99–4089) per case to €7844 (range: 104–25 615) depending on the lesion’s grade. One-year healing rates are 85.2% for grade A and 71.7%, 84.6% and 33.3% for the grades B, C and D respectively. The model-based comparison for treatment costs shows a cost reduction of 29.8% per patient year in grade A ulcerations and 49.7% in grade D for intensified versus standard treatment due to lower amputation rates. Conclusions 

These results are the first cost data for diabetic foot care in Austria and demonstrate the advantages of intensified care over standard care in terms of patient-oriented outcome and financial impact pleading for the implementation of specialized foot care facilities and referral guidelines to standardize and improve treatment.
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Keywords: Markov model; amputation; costs; diabetes; foot ulcer

Document Type: Research Article

Affiliations: 1: Health Management Researcher, JOANNEUM RESEARCH Forschungsgesellschaft mbH, Institute of Medical Technologies and Health Management, Graz, Austria 2: Statistician, Health Management Researcher, JOANNEUM RESEARCH Forschungsgesellschaft mbH, Institute of Medical Technologies and Health Management, Graz, Austria 3: Diabetologist, Department of Internal Medicine, Diabetes and Metabolism, Medical University Graz, Graz, Austria 4: Diabetes Nurse, Department of Internal Medicine, Diabetes and Metabolism, Medical University Graz, Graz, Austria 5: General Manager, Human.technology. Styria GmbH, Graz, Austria 6: Professor, Institute of Biomedical Engineering, Graz University of Technology, Graz, Austria

Publication date: 01 December 2007

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